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Understanding the Menstrual Cycle: A Complete Guide

The menstrual cycle is a monthly hormone-driven process preparing the uterus for pregnancy.

Phases & Hormonal Orchestration

  1. Menstruation (Days 1–5): Endometrial shedding (spiral artery vasoconstriction, MMPs). Low E₂/P₄ → FSH rise.
  2. Follicular Phase (Days 1–13): FSH → follicular recruitment → dominant follicle → estradiol (E₂) surge → endometrial proliferation.
  3. Ovulation (Day ~14): LH surge (positive feedback) → follicular rupture → oocyte release.
  4. Luteal Phase (Days 15–28): Corpus luteum → progesterone (P₄) + E₂ → secretory endometrium (implantation window). If no pregnancy → CL regression → hormone drop → menses.

Cycle Metrics

  • Length: 21–35 days (avg 28); variability ±7 days normal.
  • Flow: 30–80 mL; >80 mL = menorrhagia.
  • Duration: 2–7 days.

Common Symptoms

  • Physical: Cramps (prostaglandins), back pain, breast tenderness, headache, bloating, fatigue.
  • Emotional: Irritability, sadness, anxiety, brain fog (PMS/PMDD).

Menstrual Products

Tampons, pads, menstrual cups, period underwear, reusable cloth pads—choose based on flow, comfort, sustainability, cost.

Hygiene & Red Flags

  • Change products every 4–8h; wash hands; no douching; fragrance-free.
  • See clinician for: cycles <21 or >35d, heavy bleeding (soaking >1 pad/hr), severe pain (dysmenorrhea unresponsive to NSAIDs), intermenstrual bleeding, postcoital bleeding, amenorrhea >3 mo.

Menstruation is a vital sign; tracking empowers health awareness.

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